VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1277470
Sex: M
Age: 14
State: AZ

Vax Date: 04/30/2020
Onset Date: 04/30/2020
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Error: Patient Too Young for Vaccine Administered

Other Meds:

Current Illness:

ID: 1277471
Sex: F
Age: 54
State: MA

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Gluten intolerence

Symptom List: Anxiety, Dyspnoea

Symptoms: All over muscle and joint pain/aches Fatigue Pain at injection site

Other Meds: Ventlafaxine 37.5 Vit D 3. 2000u Estridol .5

Current Illness: None

ID: 1277472
Sex: F
Age: 47
State: CA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Additional Details: Patient reports dizziness, muscle weakness, and headache immediately after administration of vaccine. Patient was given benadryl once. Patient refused epinephrine injection. 911/paramedics were called and assisted patient.

Other Meds:

Current Illness:

ID: 1277473
Sex: F
Age: 53
State: PA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin Latex Nasal Inhalers Scallop

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Hair start falling off a lot Constant Migraine Headaches in daily basis

Other Meds: LANTUS NOVOLOG HYDROXYZINE HCL 50 MG TABLET

Current Illness: Diabetes

ID: 1277474
Sex: M
Age: 36
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever of 101 and chills, inability to sleep during the night, aches, and small bouts of chills for the next 24 hours. Increased resting heart rate + 10 to 25 beats per min.

Other Meds: None

Current Illness:

ID: 1277475
Sex: M
Age: 54
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Systemic: Hyperglycemia -Medium, Additional Details: Pt has Type 1 diabetes and he experience hyperglycemia episode daily after the first dose. He is currently on an insulin pump and he noticed that his sugar level was higher than normal after the first dose. It started the day after the first dose and continued for 2 weeks. His sugar level has gone back to normal during his second visit.

Other Meds:

Current Illness:

ID: 1277476
Sex: F
Age: 55
State: FL

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 1st shot sore arm , fatigue lasted for 3 days. 2nd shot fatigue , sore arm and swollen, fever, chills, headache , nausea

Other Meds: 40 mg pepcid daily

Current Illness: None

ID: 1277477
Sex: F
Age: 36
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Pain at injection site, pain throughout my left arm, pain in left armpit, fever up to 102 degrees, chills, body aches, headache, and tiredness. Nearly all of these symptoms started 7 hours after injection. I took one 200mg Motrin 15 hours after injection to keep the fever down. I don?t believe my fever got any higher than 101 since the Motrin. Forty-eight hours later and I feel much better. I still have pain in my arm and armpit.

Other Meds:

Current Illness:

ID: 1277478
Sex: F
Age: 27
State: CO

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Visual Changes/Disturbances-Mild

Other Meds:

Current Illness:

ID: 1277479
Sex: F
Age: 38
State: WI

Vax Date: 03/30/2021
Onset Date: 04/21/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Client had a breakthrough covid-19 infection. Symptom onset 4/21/21. Client was fully vaccinated with J&J on 3/30/21.

Other Meds:

Current Illness:

ID: 1277480
Sex: F
Age: 82
State: ME

Vax Date: 03/16/2021
Onset Date: 04/08/2021
Rec V Date: 05/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Blood infection that could not be identified. Required 2 multiple day hospitalizations

Other Meds:

Current Illness: None

ID: 1277481
Sex: M
Age: 63
State: NJ

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Alopecia Areata - started losing hair on scalp, chest, back, legs, buttocks ... both general loss and typical circular patterns

Other Meds: Enbrel 50mg weekly

Current Illness: None

ID: 1277482
Sex: F
Age: 47
State: CO

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Mild, Systemic: shooting arm pain from under deltoid to hand-Mild, Error: Wrong Route (SC, IM, etc.)

Other Meds:

Current Illness:

ID: 1277483
Sex: F
Age: 49
State: CO

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Site: Swelling at Injection Site-Mild, Systemic: bleeding down arm/pt concerned of non OSHA compliance(lack of glove use to wipe dry blood off of arm)-Mild, Additional Details: pt's vaccine site started bleeding after needle was removed. immunizer cleaned the blood that was dripping down her arm off with a glove on and made sure she stopped bleeding, but took blood covered glove off and finished wiping off the dry blood with an alcohol swab. Patient called and told pharmacist her concerns about the incident.

Other Meds:

Current Illness:

ID: 1277484
Sex: M
Age: 20
State: PA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Peanuts, tree nuts, Penicillin, Cleocin, Amoxicillin

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: 04/29/2021 5:30pm - chills, pins & needles, soreness 8:00pm - 100.8 degree fever, chills, soreness, joint pain; two 200mg ibuprofen tablets take & cold wet towel placed on forehead 9:30pm - 101.2 degree fever, chills, soreness, joint pain 11pm - trouble sleeping, confusion, chills, soreness 04/30/2021 1:00am - fever, chills, soreness; two 200mg ibuprofen tablets take & cold wet towel placed on forehead 7:00am- 98.0 degree temperature, soreness, slight joint pain; one 200mg ibuprofen tablet taken 11:30am~5:00pm - slight occasional chest pain (around sternum) 7:00pm - soreness in arm only, headache

Other Meds:

Current Illness:

ID: 1277485
Sex: F
Age: 44
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Sore arm, very stiff neck, extreme pain in the middle upper back , extreme tiredness

Other Meds:

Current Illness: None

ID: 1277486
Sex: F
Age: 39
State: UT

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Tinnitus in right ear. Constant fluttering and pulsing sound. Have never had this occur prior to getting the vaccine.

Other Meds: Tylenol and ibuprofen

Current Illness: None

ID: 1277487
Sex: F
Age: 48
State: NC

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: My symptoms began with all-over body-aches, chilling and fever on the night of April 22. The adverse event that I feel is noteworthy to report is I had chest pain that began on April 23 in the afternoon and became more severe throughout the night and the entire next day on Saturday, April 24th. The chest pains were accompanied by a fever of 102.3. The chest pains were milder on Sunday and resolved by Monday, April 26, 2021.

Other Meds: multi-vitamin

Current Illness: none

ID: 1277488
Sex: F
Age: 52
State: OH

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 05/01/2021
Hospital: Y

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: amlodipine -> facial swelling

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: She was admitted on 4/29 for altered mental status. She received her second dose of COVID vaccination on 4/27 at 0700 and her son reported that 2h after the vaccination she started to act strange with labile mood, but mostly intermittently tearful. Later that evening after 5pm she became confused (at times not recognizing who her son was) with worsening intermittent agitation, labile moods, singing, and reporting visual hallucinations. Denied SOB, chest pain, fevers, chills, n/v/d, new medications... Per son she is A&Ox4 at baseline and no history of mental illnesses.

Other Meds: chlorthalidone 25mg daily, verapamil 180mg daily, losartan 100mg daily, levothyroxine 50mcg daily, amitriptyline 10 mg qhs, flovent 1010mcg 1 puff bid, singulair 10mg daily, latanoprost (XALATAN) 0.005 % ophthalmic solution 1 drop both eyes

Current Illness: n/a

ID: 1277489
Sex: F
Age: 22
State: OR

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1277490
Sex: F
Age: 31
State: IL

Vax Date: 04/23/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: amoxicillin and azithromycin

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: I felt mild side effects on the first day of the dose for a few hours (slight dizziness, aches, some chills) and soreness in my upper left arm but these went away within a day or two. Then, on day 7, I woke up with swelling around the injection site on my left arm with a lump and tenderness. Today is day 8 post-vaccine and while the swelling has gone down a little, the area is tender and there is a light red mark around it (it looks a bit like a very large mosquito or spider bite). The area is not painful, but it is tender and feels swollen.

Other Meds: None

Current Illness: none

ID: 1277491
Sex: F
Age: 74
State: RI

Vax Date: 04/03/2021
Onset Date: 04/18/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Cipro , Tylenol with Codeine, Iodine and statins

Symptom List: Unevaluable event

Symptoms: last two weeks dizziness,cold chills,wicked headache,tiredness,diareahea,leg cramps,nausea

Other Meds: none

Current Illness: none

ID: 1277492
Sex: M
Age: 41
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Started feeling real nauseous and fatigued. Nauseous let up a little after 2 hours. I drank pedialyte at times to stay hydrated. Slept the rest of the night. Woke up at 6:30am on 04/30/2021, still real fatigued and slight nauseous. Slept most of the day. Except to sip pedialyte and eat crackers. Finally feel better on 05/01/2021.

Other Meds: None

Current Illness: None

ID: 1277493
Sex: F
Age: 45
State: OH

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN & Seroquil

Symptom List: Injection site pain, Pain

Symptoms: Left arm from shoulder down through tips of fingers feels like 1,000 little pin pricks of electricity. I have a weakened grip also. It started within 30 minutes of getting the vaccine and has not let up at all. If I stretch my arm above my head, the feeling is stronger and sharper (the electrical pin pricks). Other symptoms are the same as the first vaccine injection I received (April 8, 2021 Pfizer lot #ER8727) which were and are nausea and tiredness.

Other Meds: None

Current Illness: None

ID: 1277494
Sex: M
Age: 38
State: PA

Vax Date: 03/03/2021
Onset Date: 04/22/2021
Rec V Date: 05/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: nkda

Symptom List: Injection site pain, Menorrhagia

Symptoms: pt developed pericarditis 3 weeks after 2nd Moderna injection

Other Meds: Wellbutrin, valium, trazodone, protonix, advair

Current Illness: none

ID: 1277495
Sex: F
Age: 32
State: CO

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Site: Itching at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Additional Details: Gave patient benadryl and had her stay for 30 minutes after vaccine.

Other Meds:

Current Illness:

ID: 1277496
Sex: M
Age: 22
State: UT

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fatigue, nausea, fever, chills, headache, gastrointestinal problems, soreness

Other Meds:

Current Illness:

ID: 1277497
Sex: F
Age: 36
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever, chills, body aches, severe headache, severe fatigue, middle back pain that was much worse than other body aches - 1 day of severe flu like symptoms, day 2 - similar but much more mild symptoms and no longer have a fever

Other Meds: None

Current Illness: None

ID: 1277498
Sex: F
Age: 51
State: CA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Breathing-Medium

Other Meds:

Current Illness:

ID: 1277500
Sex: F
Age: 40
State: ID

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Cinnamon

Symptom List: Nausea

Symptoms: Swollen under eye (right) 26 hours after second dose. Took 50mL benadryl. Practitioner prescribed steroid pack (methylprednisolone 4mg dosepak 21s). Approximately 24 hours after vaccine, the left under eye assist started to swell. History of dermal fillers. Particular area where swelling is occurring has not been treated in ~2 years. Other areas treated more recently ( nasolabial, cheek, lips) are not experiencing noticable swelling or tenderness. Note: swelling is minimal discomfort, barely noticable unless pointed out, some tenderness but otherwise bearable.

Other Meds: None

Current Illness: None

ID: 1277501
Sex: M
Age: 25
State: GA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fever-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hyperventilation-Mild, Systemic: Shakiness-Mild, Systemic: Stroke-Mild, Systemic: Weakness-Mild, Additional Details: patient was nervous and was hesistant about needles just prior to vaccination. as soon as the vaccinnation was done, patient became tense and seizure like activity for ~10 seconds, then he became coherent and was sweating/ pale/ feverish. Gave the patient water, ice packs, and offered to call 911 once he was coherent. Patient refused and then called friend to take him home.

Other Meds:

Current Illness:

ID: 1277502
Sex: F
Age: 57
State: VA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NO

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Chest tightening (Major), Left shoulder muscular spasms that moved up to MAJOR muscle spasms on left side of neck, moved to upper back, and over to right muscle in neck (major), fog Also had MAJOR Head ringing, light headed vertigo (I can't even describe) I felt like everyone was yelling and my head was in a fog.

Other Meds: Vitamins B,C,D Folic Acid Biotin Fish Oil B12 Shot Calcium, Magnesium, Zinc

Current Illness: NONE

ID: 1277503
Sex: F
Age: 45
State: MA

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Cipro

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Had menstrual spotting (light bleeding) that began 1 day after the shot. My period had ended 1 week prior and I do not spot mid-month. The spotting lasted for 2 days.

Other Meds: none

Current Illness: none

ID: 1277504
Sex: F
Age: 35
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NA

Symptom List: Tremor

Symptoms: Fever, started at 102 but kept around 99-100 with medication. Body aches, headache, chills

Other Meds: Bupropion

Current Illness: NA

ID: 1277505
Sex: M
Age: 64
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Chills,headache, nausea

Other Meds: Atorvastatin 20mg, Men's multivitamin

Current Illness: None

ID: 1277506
Sex: F
Age: 43
State: VA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Severe, Additional Details: Patient received the injection. After a couple of minutes, patients breathing became rapid. I tried to calm her down. A couple of minutes the patient said her throat was closing. She made some gasping sounds. I gave her an injection of epinephrine 0.3mg. i called 911. EMS took her to unspecified hospital after treating her.

Other Meds:

Current Illness:

ID: 1277507
Sex: F
Age: 36
State: VA

Vax Date: 03/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/a

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Extremely heavy menses about a week after my first vaccination. Currently over due and absent period -More than 5 days late at this point and no chance of pregnancy.

Other Meds: Synthroid 50mcg Toporol 12.5 mg Insulin

Current Illness: N/a

ID: 1277508
Sex: M
Age: 55
State: MA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Severe

Other Meds:

Current Illness:

ID: 1277509
Sex: F
Age: 44
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Fever, chills, body aches, fatigue

Other Meds:

Current Illness:

ID: 1277510
Sex: F
Age: 33
State: IN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Headache, chills, fever

Other Meds:

Current Illness:

ID: 1277511
Sex: M
Age: 35
State: IN

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Chills, body ache, head ache, exhaustion, fogginess, loss of appetite

Other Meds: Tylenol and nexium

Current Illness:

ID: 1277512
Sex: M
Age: 19
State: MA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Systemic: Weakness-Mild, Additional Details: PATIENT STATED HE'S AFRAID OF NEEDLES.

Other Meds:

Current Illness:

ID: 1277513
Sex: F
Age: 74
State: NJ

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: cats, honeydew melon

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Even today, May 1, I have some stomach discomfort and continuing fatigue that lessens over time. I had headaches but they are mostly gone now.

Other Meds: Vitamins B, D. Magnesium.

Current Illness: sciatica

ID: 1277514
Sex: M
Age: 57
State: TN

Vax Date: 02/11/2021
Onset Date: 02/22/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NONE

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: I had feelings of vertigo and partial hearing loss in my left ear. My balance was off when walking and I felt like I was going to pass out or fall. The vertigo was relieved when I sat or laid down. This symptoms left after a day but the vertigo lasted for 2 weeks or longer with both injections. It has been over a month since I had both injections and both adverse reactions have now disappeared.

Other Meds: AMLODIPINE 5MG-QAM&QHS, TRIAM/HCTZ-37.5-25-QAM, ASA 81MG-QAM, ALLOPURINOL 300MG-QPM, COLCHICINE 0.6MG-QPM, CLONIDINE 0.1MG-QHS, BENADRYL 25MG-QHS

Current Illness: NONE

ID: 1277515
Sex: F
Age: 31
State: MA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Mild, Systemic: Weakness-Mild, Additional Details: pt gets nervous during shots

Other Meds:

Current Illness:

ID: 1277516
Sex: F
Age: 51
State:

Vax Date: 04/05/2021
Onset Date: 04/07/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Mild lymphadenopathy at right arm for two days starting on the second day after the injection

Other Meds: None

Current Illness: None

ID: 1277517
Sex: F
Age: 41
State: MN

Vax Date: 04/02/2021
Onset Date: 04/09/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Moderate tinnitus in both ears. Developed about a week after second dose. No change a month later.

Other Meds: escitalopram

Current Illness: none

ID: 1277518
Sex: M
Age: 25
State: OR

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/a

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Dizzy, shortly after, goes away after a few hours. Sore arm, exercise helps and goes away in about a day Headache, 8-12 hours after. Goes away the next day. Intense Nightmares, the night after the second dose

Other Meds: Omeprazole, fluticasone, allegra

Current Illness: N/a

ID: 1277519
Sex: M
Age: 48
State: IL

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1277520
Sex: M
Age: 60
State: CA

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Eggs.

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Sore arm at site of injection. Not improving after 24 hours. Disturbing sleep. Not happy.

Other Meds: N/A

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm